Socio-demographic and environmental determinants of infectious disease morbidity in children under 5 years in Ghana

Figures & data

Table 1 Descriptive analysis of the sample (n=2,790): continuous and categorical variables

Variables	Mean±SD/%
Child age (in months)	27.74±17.58
Mother age (in years)	30.08±7.01
Child sex
Male	51.0
Female	49.0
Vaccinations
Polio 3 (yes)	71.8
DPT/Hep B/influenza 3 (yes)	75.2
BCG (yes)	91.3
Maternal education
No education	37.8
Primary	24.1
Secondary +	38.0
Disposal of the youngest child's stool
Inappropriate	49.0
Type of toilet facility
Unimproved	46.2
Source of drinking water
Unimproved	22.5
Place of residence
Urban	33.4
Rural	66.6

Mean±SD=means and standard deviations of continuous variables.

Table 2 Prevalence of diarrhoea and cough by selected environmental and socio-demographic factors (n=2,790)

	Diarrhoea		Cough
Variables	%	p	%	p
Child age (in months)
0–5	9.5	0.001	13.0	0.001
6–11	26.7		28.0
12–23	32.4		27.9
24 +	17.2		20.9
Sex of child
Male	21.0	0.90	22.5	0.87
Female	20.8		22.3
Maternal age (in years)
15–24	21.3	0.611	25.9	0.018
25–34	20.1		20.3
35–49	21.8		23.1
Education level
No education	24.4	0.001	20.2	0.008
Primary	20.6		26.6
Secondary +	17.6		21.9
Disposal of the youngest child's stool
Appropriate	17.3	0.001	22.4	0.97
Inappropriate	24.3		22.4
Type of toilet facility
Improved	18.9	0.005	23.4	0.19
Unimproved	23.2		21.3
Source of drinking water
Improved	21.0	0.95	23.1	0.13
Unimproved	20.9		20.3
Floor material
Non-dirt	20.2	0.076	22.8	0.51
Dirt	23.4		21.6
Presence of co-wives
There are no co-wives	18.1	0.001	21.7	0.58
There are co-wives	27.4		23.0
Type of place of residence
Urban	18.5	0.033	24.8	0.034
Rural	22.0		21.2
Overall prevalence	20.9		22.4

Table 3 Multiple logistic regression analysis of the socio-demographic and environmental determinants of childhood diarrhoea (n=2,790)

	Model 1		Model 2		Model 3		Model 4
Variables	OR	95% CI for OR	OR	95% CI for OR	OR	95% CI for OR	OR	95% CI for OR
Maternal and child biological factors
Child age (in months)
0–5	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
6–11	3.48	2.23, 5.44**	3.54	2.20, 5.71**	3.49	2.05, 5.96**	3.31	1.87, 5.85**
12–23	4.57	3.03, 6.90**	4.70	3.00, 7.36**	4.92	2.97, 8.16**	4.55	2.64, 7.78**
24 +	1.93	1.30, 2.87**	2.00	1.31, 3.07**	2.05	1.27, 3.31**	1.96	1.18, 3.25**
Sex of child
Male	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Female	0.94	0.78, 1.14	0.94	0.77, 1.13	0.99	0.80, 1.22	0.98	0.78, 1.23
Maternal age in years
15–24	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
25–34	0.97	0.76, 1.23	0.98	0.76, 1.25	1.04	0.78, 1.37	1.14	0.83, 1.57
35–49	1.18	0.90, 1.55	1.18	0.90, 1.54	1.22	0.90, 1.66	1.19	0.84, 1.69
Child level factors
Breastfeeding status	–	–
Breastfeeding	–	–	Ref	Ref	Ref	Ref	Ref	Ref
Not breastfeeding	–	–	1.18	0.93, 1.50	1.33	1.03, 1.73**	1.48	1.11, 1.98**
Polio 3 vaccination	–	–
Vaccinated	–	–	Ref	Ref	Ref	Ref	Ref	Ref
Not vaccinated	–	–	0.68	0.46, 0.99**	0.72	0.48, 1.08	0.77	0.50, 1.19
DPT/Hep B/influenza 3 vaccination	–	–
Vaccinated	–	–	Ref	Ref	Ref	Ref	Ref	Ref
Not vaccinated	–	–	1.53	1.03, 2.26**	1.41	0.92, 2.16	1.28	0.81, 2.01
Maternal level factors
Education level	–	–	–	–
Secondary +	–	–	–	–	Ref	Ref	Ref	Ref
Primary	–	–	–	–	0.93	0.67, 1.29	0.91	0.63, 1.31
No education	–	–	–	–	1.11	0.81, 1.52	1.03	0.71, 1.49
Has a say in decision-making index	–	–	–	–	0.94	0.87, 1.01	0.99	0.91, 1.09
Wife beating not justified index	–	–	–	–	0.86	0.80, 0.91**	0.86	0.80, 0.92**
Can refuse husband sex index	–	–	–	–	0.89	0.79, 1.01	0.93	0.82, 1.07
Household level factors
Disposal of the youngest child's stool	–	–	–	–	–	–
Appropriate	–	–	–	–	–	–	Ref	Ref
Inappropriate	–	–	–	–	–	–	1.24	0.98, 1.58
Type of toilet facility	–	–	–	–	–	–
Improved	–	–	–	–	–	–	Ref	Ref
Unimproved	–	–	–	–	–	–	0.98	0.74, 1.30
Source of drinking water	–	–	–	–	–	–
Improved	–	–	–	–	–	–	Ref	Ref
Unimproved	–	–	–	–	–	–	0.97	0.74, 1.28
Floor material	–	–	–	–	–	–
Non-dirt	–	–	–	–	–	–	Ref	Ref
Dirt	–	–	–	–	–	–	1.05	0.77, 1.42
Presence of co-wives	–	–	–	–	–	–
There are no co-wives	–	–	–	–	–	–	Ref	Ref
There are co-wives	–	–	–	–	–	–	1.74	1.33, 2.27**
Household wealth index	–	–	–	–	–	–
Richest	–	–	–	–	–	–	Ref	Ref
Rich	–	–	–	–	–	–	1.22	0.72, 2.05
Middle	–	–	–	–	–	–	1.77	1.03, 3.06**
Poor	–	–	–	–	–	–	1.45	0.80, 2.65
Poorest	–	–	–	–	–	–	1.72	0.88, 3.35
Type of place of residence	–	–	–	–	–	–
Urban	–	–	–	–	–	–	Ref	Ref
Rural	–	–	–	–	–	–	0.97	0.68, 1.37

OR, odds ratios; CI, confidence intervals.

**Significant at p<0.05.

Table 4 Multiple logistic regression analysis of the socio-demographic and environmental determinants of childhood cough (n=2,790)

	Model 1		Model 2		Model 3		Model 4
Variables	OR	95% CI for OR	OR	95% CI for OR	OR	95% CI for OR	OR	95% CI for OR
Maternal and child biological factors
Child age (in months)
0–5	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
6–11	2.64	1.76, 3.97**	2.64	1.70, 4.09**	2.92	1.81, 4.71**	2.63	1.59, 4.33**
12–23	2.63	1.81, 3.83**	2.62	1.74, 3.96**	2.73	1.74, 4.30**	2.46	1.53, 3.96**
24 +	1.83	1.29, 2.59**	1.85	1.26, 2.70**	1.92	1.27, 2.92**	1.76	1.14, 2.73**
Sex of child
Male	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Female	0.98	0.89, 1.18	0.98	0.81, 1.17	1.02	0.84, 1.25	0.98	0.80, 1.22
Maternal age in years
15–24	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
25–34	0.73	0.58, 0.92**	0.74	0.59, 0.93**	0.76	0.58, 0.98**	0.69	0.52, 0.92**
35–49	0.88	0.68, 1.13	0.87	0.67, 1.12	0.98	0.74, 1.32	0.89	0.65, 1.21
Child level factors
Breastfeeding status	–	–
Breastfeeding	–	–	Ref	Ref	Ref	Ref	Ref	Ref
Not breastfeeding	–	–	1.28	1.02, 1.60**	1.31	1.02, 1.68**	1.24	0.95, 1.62
Polio 3 vaccination	–
Vaccinated	–	–	Ref	Ref	Ref	Ref	Ref	Ref
Not vaccinated	–	–	087	0.61, 1.24	0.81	0.55, 1.19	0.81	0.54, 1.21
DPT/HepB/influenza 3 vaccination	–	–
Vaccinated	–	–	Ref	Ref	Ref	Ref	Ref	Ref
Not vaccinated	–	–	1.15	0.79, 1.67	1.27	0.85, 1.90	1.30	0.85, 1.99
Maternal level factors
Education level	–	–	–	–
Secondary +	–	–	–	–	Ref	Ref	Ref	Ref
Primary	–	–	–	–	1.40	1.03, 1.89**	1.53	1.10, 2.14**
No education	–	–	–	–	0.99	0.73, 1.37	1.08	0.75, 1.55
Has a say in decision-making index	–	–	–	–	0.98	0.92, 1.06	1.02	0.93, 1.11
Wife beating not justified index	–	–	–	–	0.88	0.83, 0.94**	0.89	0.83, 0.96**
Can refuse husband sex index	–	–	–	–	0.86	0.77, 0.97**	0.86	0.76, 0.97**
Household level factors
Disposal of the youngest child's stool	–	–	–	–	–	–
Appropriate	–	–	–	–	–	–	Ref	Ref
Inappropriate	–	–	–	–	–	–	1.02	0.81, 1.28
Type of toilet facility	–	–	–	–	–	–
Improved	–	–	–	–	–	–	Ref	Ref
Unimproved	–	–	–	–	–	–	0.80	0.61, 1.05
Source of drinking water	–	–	–	–	–	–
Improved	–	–	–	–	–	–	Ref	Ref
Unimproved	–	–	–	–	–	–	0.90	0.69, 1.17
Floor material	–	–	–	–	–	–
Non-dirt	–	–	–	–	–	–	Ref	Ref
Dirt	–	–	–	–	–	–	0.86	0.64, 1.17
Presence of co-wives	–	–	–	–	–	–
There are no co-wives	–	–	–	–	–	–	Ref	Ref
There are co-wives	–	–	–	–	–	–	1.13	0.56, 1.48
Household wealth index	–	–	–	–	–	–
Richest	–	–	–	–	–	–	Ref	Ref
Rich	–	–	–	–	–	–	1.52	0.94, 2.24
Middle	–	–	–	–	–	–	1.54	0.94, 2.38
Poor	–	–	–	–	–	–	1.81	1.08, 3.04**
Poorest	–	–	–	–	–	–	1.98	1.09, 3.60**
Type of place of residence	–	–	–	–	–	–
Urban	–	–	–	–	–	–	Ref	Ref
Rural	–	–	–	–	–	–	0.77	0.57, 1.06

OR, odds ratios; CI, confidence intervals.

**Significant at p<0.05.